2017-05-14T16:14:01-05:00 2016-06-30 ERNST & YOUNG US LLP 18101 VON KARMAN AVE STE 1700 IRVINE CA 92612 990 2015-07-01 752765566 COVENANT HEALTH SYSTEM % DYANA KERR COVE 8067250000 3615 19TH STREET LUBBOCK TX 794101203 WALTER CATHEY CEO 8067250000 2017-05-11 true KARA ADAMS P00023315 9497942300 2015 2021-01-29 14:40:06Z COVENANT HEALTH RICHARD PARKS 3615 19TH STREET LUBBOCK TX 794101203 717681259 false X WWW.COVENANTHEALTH.ORG X 1998 TX SEE SCHEDULE O 19 15 4485 120 7533435 -78819 5178762 10560788 687624779 703316607 10207197 3803864 0 0 703010738 717681259 6016841 4045752 0 0 221506115 215238478 0 0 0 399191795 430974061 626714751 650258291 76295987 67422968 723200992 794676007 202712351 178570192 520488641 616105815 X SEE SCHEDULE O false false 610490864 4045752 703316607 SEE SCHEDULE O 610490864 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false true true false false false true true true true false false true X 0 0 true 4485 true true true false false false false false false false false false X 19 15 false false false false true true true true true false false true true true true true true false true true false TX X DYANA KERR 8067255234 2107 Oxford Lubbock TX 79410 JOHN HAMILTON BOARD CHAIR/COMMITTEE CHAIR 6.0 6.0 X 0 0 0 BRIAN BRUENING MD BOARD MBR/COMMITTEE V. 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CHAIR 3.0 3.0 X 0 0 0 SISTER SHARON BECKER CSJ BOARD MEMBER/COMMITTE CHAIR 2.0 48.0 X 0 0 0 WALTER CATHEY CHS CEO 50.0 0.0 X 452431 0 40055 JOHN GRIGSON SVP CHIEF FINANCIAL OFFICER 26.0 24.0 X 679504 0 29376 ROBERT TURNER VP MISSION INTEGRATION 26.0 24.0 X 311067 0 25145 JAMES KELLY SECRETARY 20.0 30.0 X 0 357748 28095 CRAIG RHYNE MD CHIEF MEDICAL OFFICER 50.0 0.0 X 882270 0 39731 KAREN BAGGERLY VP NURSING 50.0 0.0 X 435101 0 30964 SHARON PRATHER Chief Governance Officer 31.0 19.0 X 373082 0 38803 CHRISTINE SHAVER VP Human Resources - COVHS 50.0 0.0 X 324429 0 35324 DYANA KERR Regional VP, Finance 50.0 0.0 X 188403 0 28910 CHRIS DOUGHERTY CEO CHILDREN'S HOSPITAL 0.0 50.0 X 0 436606 31375 SHARON CLARK VP FINANCE 50.0 0.0 X 151042 0 16905 ROBERT SALEM MD SVP Medical Director, Emeritus 48.0 2.0 X 572679 0 41143 LAWRENCE MARTINELLI Chief Med Informatics Officer 50.0 0.0 X 474543 0 22027 STEVEN BECK SVP Reg Svcs & Gov't Relation 30.0 20.0 X 370768 0 36467 MURALI NAIR Chief Medical Physicist 50.0 0.0 X 330096 0 37587 KELLY MCDANIEL VP Support Services 50.0 0.0 X 295890 0 39954 TROY THIBODEAUX FORMER CEO 0.0 50.0 X 0 995109 10667 STEVE MCCAMY CMG PRESIDENT (FMR KEY EMPLY) 0.0 40.0 X 0 591224 14699 ALAN KING VP REG HOSPITAL (FMR KEY EMP) 0.0 0.0 X 211374 0 0 6058679 6649471 716745 276 true true false NORTHSTAR ANESTHESIA PA 6225 N STATE HIGHWAY 161 IRVING TX 75038 ANESTHESIA SERVICES 7743585 UNITED BLOOD SERVICES PO BOX 53022 PHOENIX AZ 85072 BLOOD SERVICES 2949072 TEXAS TECH UNIV HEALTH SCIENCES CE 3601 4TH STREET LUBBOCK TX 79430 RESIDENCY PROGRAM 2197465 POLSINELLI PC PO BOX 8786 KANSAS CITY MO 64187 CONSULTING SERVICES 1332978 QUEST DIAGNOSTICS INC 3924 COLLECTION CENTER DRIVE CHICAGO IL 60693 LAB SERVICES 1212213 42 0 8878688 1682100 1317701 10560788 PATIENT SERVICES REVENUE 622110 556035575 556035575 0 0 MOB RENTAL REVENUE 531120 9670377 9670377 0 0 OUTREACH LAB SERVICES 621511 3925849 0 3925849 0 CAFETERIA REVENUE 722310 3488132 3488132 0 0 BILLING/MANAGEMENT FEE 541611 3607586 0 3607586 0 126589088 126589088 0 703316607 3803864 3803864 0 0 0 0 0 0 0 0 0 0 717681259 695783172 7533435 3803864 X 4045752 4045752 0 0 0 0 0 3658422 0 3658422 0 0 0 0 0 146563559 143968239 2595320 0 9421380 9001653 419727 0 43014929 41793106 1221823 0 12580188 12156550 423638 0 125280792 106674792 18606000 0 2911183 0 2911183 0 5500 0 5500 0 71779 71779 0 0 0 0 0 0 0 0 104162167 100031708 4130459 0 2427662 61317 2366345 0 5694400 4704699 989701 0 11595336 10345295 1250041 0 0 0 0 0 8807257 8806568 689 0 574256 424620 149636 0 0 0 0 0 214917 153249 61668 0 5548353 5548353 0 0 0 0 0 0 28074631 28074631 0 2601064 2385778 215286 0 MEDICAL SUPPLIES 130915648 130224381 691267 0 ALL OTHER EXPENSES 2089116 2018394 70722 0 650258291 610490864 39767427 0 0 5762247 11604915 33453091 43646276 0 0 77930435 77017573 0 0 0 0 102298 102298 8755106 10092136 1444432 1740702 922927253 647302609 252051031 275624644 103243775 87232354 21857524 24201165 0 0 0 0 218601053 263413944 723200992 794676007 39677805 41615036 0 0 0 0 0 0 0 0 0 0 2006639 1721128 0 0 161027907 135234028 202712351 178570192 X 520488641 616105815 0 0 0 0 520488641 616105815 723200992 794676007 X 67422968 -6085844 0 0 0 34280050 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 71779 71779 false SCHEDULE C, PART II-B, LINE 1I PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS FOR LOBBYING ACTIVITIES DURING THE YEAR, ST. JOSEPH HEALTH SYSTEM CONDUCTED ADVOCACY EFFORTS WHICH INCLUDED SOME LOBBYING ACTIVITIES. THESE ACTIVITIES INCLUDED MEETING WITH LOCAL, STATE AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS, AS WELL AS COMMUNICATION TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION. THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO COVENANT HEALTH SYSTEM. 18307431 18307431 428763524 319139896 109623628 23642122 17043750 6598372 390758873 311118963 79639910 61455303 0 61455303 275624644 LT DUE FROM AFFILIATES 253156692 OTHER RECEIVABLES 8039344 ASSETS HELD IN TRUST 1568595 DEFERRED FINANCING ASSETS 635401 BOARD DESIGNATED ASSETS 13912 263413944 0 LT NOTES 98587546 PAYABLE TO THIRD PARTY PAYORS 18673136 CURRENT MATURITY OF LT DEBT 15151706 OTHER LIABILITIES 2821640 135234028 X SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2016 OR 2015. true true X true X 175. true X true true true false true true 27316380 27316380 0.04030 51234053 39689582 11544471 0.01700 1428781 16422 1412359 0.00210 79979214 39706004 40273210 0.05940 2009937 98964 1910973 0.00280 19372403 4467152 14905251 0.02200 442671 442671 0.00070 21825011 4566116 17258895 0.02550 101804225 44272120 57532105 0.08490 false 37115370 123096147 179585131 -56488984 X true true COVENANT L-T CARE LP LONG-TERM CARE 0.7 0.3 LUBBOCK SURG CTR LTD HEALTHCARE 0.6 0.4 METHODIST DIAGNOSTIC HEALTHCARE 0.6 0.4 COVENANT HP SURG CTR HEALTHCARE 0.24 0.76 2 1 COVENANT MED CENTER-LAKESIDE CAMPUS 4000 24TH STREET LUBBOCK TX 79410 WWW.COVENANTHEALTH.ORG 465 X X X X X A 2 COVENANT MEDICAL CENTER 3616 19TH STREET LUBBOCK TX 794101203 WWW.COVENANTHEALTH.ORG 465 X X X X A A false false true X X X X X X X X X 13 true true false true X SEE SCHEDULE H, PART V, SECTION C X true 13 true SEE SCHEDULE H, PART V, SECTION C false true X 175. 300. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM COMMUNITY REPRESENTATIVES COMMUNITY INPUT WAS GATHERED THROUGH FOCUS GROUPS, INTERVIEWS AND AN ON-LINE SURVEY CONDUCTED DURING JANUARY 2014. INPUT WAS GATHERED BASED ON THE HEALTH NEEDS THAT SURFACED IN THE 2012 PRC HEALTH NEEDS ASSESSMENT (FULL PDF REPORT AVAILABLE UPON REQUEST) PREPARED FOR COVENANT HEALTH. THE PRC NEEDS ASSESSMENT ANALYZED BOTH PRIMARY AND SECONDARY DATA FOR COVENANT HEALTH INCLUDING PHONE SURVEYS OF COMMUNITY RESIDENTS. FOCUS GROUPS, INTERVIEWS AND SURVEYS WERE CONDUCTED BY COVENANT HEALTH COMMUNITY OUTREACH STAFF. PERSONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY AND WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH WERE ASKED TO PARTICIPATE IN ONE OF MORE OF THE DATA GATHERING SESSIONS. INPUT WAS GATHERED FROM GOVERNMENTAL HEALTH AGENCIES, PERSONS REPRESENTING MEDICALLY UNDERSERVED AND LOW INCOME POPULATIONS, AS WELL AS INDIVIDUALS REPRESENTING MINORITY HEALTH NEEDS. REPRESENTATIVES FROM PUBLIC HEALTH OR OTHER DEPARTMENTS OR AGENCIES INCLUDING: TEXAS HEALTH AND HUMAN SERVICES COMMISSION TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER COMMUNITY HEALTH CENTER OF LUBBOCK LUBBOCK CHILDRENS HEALTH CLINIC AMERIGROUP/CHILDRENS MEDICAID STARR CARE MANAGED CARE CATHOLIC CHARITIES SOUTH PLAINS FOOD BANK SUSAN G. KOMEN FOUNDATION LUNA EAST LUBBOCK NEIGHBORHOODS EAST LUBBOCK PROMISE NEIGHBORHOOD SUPERIOR HEALTH MEDICAID AND CHIP PROGRAMS RONALD MCDONALD CHARITIES THE DREAM CENTER TEXAS TECH UNIVERSITY CENTER FOR ADOLESCENT RESILIENCY VOLUNTEER CENTER OF LUBBOCK SOUTH PLAINS COMMUNITY ACTION THE DIFFERENCE MARKERS FELLOWSHIP MARCH OF DIMES FOUNDATION TEXAS TECH SCHOOL OF NURSING WOMENS PROTECTIVE SERVICES LUBBOCK CITY COUNCIL LUBBOCK INDEPENDENT SCHOOL DISTRICT REGION 17 EDUCATION SERVICE CENTER SOUTH PLAINS ASSOCIATION OF GOVERNMENTS YWCA SCHEDULE H, PART V, SECTION B, LINE 6 CHNA HOSPITAL FACILITIES COVENANT HEALTH SYSTEMS CONDUCTED NEEDS ASSESSMENTS FOR COVENANT MEDICAL CENTER, COVENANT CHILDRENS HOSPITAL, COVENANT LEVELLAND, COVENANT PLAINVIEW AND COVENANT SPECIALTY HOSPITAL. SCHEDULE H, PART V, SECTION B, LINE 7A THE CHNA FOR COVENANT HEALTH SYSTEM CAN BE FOUND ON ITS WEBSITE AT http://www.covenanthealth.org/documents/Medical-Center-CHNA-Final-2014.pdf SCHEDULE H, PART V, SECTION B, LINE 10A http://www.covenanthealth.org/documents/Medical-Center-FY15-17-CB-Plan-Imp lementation-FINAL.pdf SCHEDULE H, PART V, SECTION B, LINE 11 BASED ON REVIEW OF PRIORITIZED SIGNIFICANT HEALTH NEEDS AND A THOUGHTFUL PRIORITY SETTING PROCESS, COVENANT HEALTH, INCLUDING COVENANT MEDICAL CENTER, COVENANT CHILDRENS HOSPITAL AND COVENANT SPECIALTY HOSPITAL WILL ADDRESS THE FOLLOWING PRIORITY AREAS AS PART OF ITS FY15-17 COMMUNITY BENEFIT (CB) PLAN: 1. WELLNESS AND PREVENTION - FOCUSED PRIMARILY ON ADULT DIABETIC EDUCATION, OBESITY PREVENTION FOR CHILDREN, ADULT CARDIAC HEALTH EDUCATION AND EARLY ORAL HEALTH INTERVENTIONS FOR CHILDREN; A FULL TIME HEALTH EDUCATOR WILL BE DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH/NUTRITION EDUCATION FOR ALL AGES; FUNDING FOR CHILDHOOD OBESITY AND WELLNESS PROGRAMS WILL BE PROVIDED TO COMMUNITY AGENCIES; PARTICIPATION IN HEALTH SCREENINGS AND HEALTH FAIRS; FUNDING FOR WELL HEART PRESENTATIONS; ORAL HEALTH EDUCATION PROVIDED ON-SITE AT ELEMENTARY SCHOOLS. 2. ORAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP; MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK; FREE REGIONAL DENTAL SEALANT CLINICS FOR SCHOOL CHILDREN. 3. MENTAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES. IN ADDITION TO THE PRECEDING PRIORITY AREAS, THE COVENANT HEALTH PLANS TO PROVIDE OTHER COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THE HEALTH NEEDS IDENTIFIED IN THE 2014 CHNA. COMMUNITY BENEFIT PROGRAMS LISTED BELOW ONLY INCLUDES ADDITIONAL COMMUNITY SERVICES FOR THE LOW-INCOME AND BROADER COMMUNITY THAT HAVE NOT BEEN PREVIOUSLY COVERED IN THIS CB PLAN/IMPLEMENTATION STRATEGY REPORT. INITIATIVES (COMMUNITY NEED BEING ADDRESSED): 1. FOOD INSECURITY - SUMMER OF SHARING FOOD DRIVE: CONDUCT FOOD DRIVE FOR SOUTH PLAINS FOOD BANK 2. CHILD ABUSE - ANNUAL CHILD ABUSE SUMMIT: HOST AND ORGANIZE AN ANNUAL CHILD ABUSE PREVENTION SUMMIT 3. CHILDRENS HEALTH FUNDING LUBBOCK CHILDRENS HEALTH CLINIC - PROVIDE FUNDING AND A DIETICIAN FOR LUBBOCK CHILDRENS HEALTH CLINIC 4. CHILDHOOD OBESITY FUNDING TEXAS TECH UNIVERSITY COVENANT BODY MIND INSTITUTE (CBMI) PROVIDE FUNDING FOR IMPLEMENTING CBMI CURRICULUM IN AREA SCHOOLS BROADER COMMUNITY 5. WOMENS HEALTH/CANCER MOBILE MAMMOGRAPHY SERVICES - MOBILE MAMMOGRAPHY SERVICES OFFERING SERVICES TO BOTH UN-INSURED AND INSURED PATIENTS 6. CARDIAC WELL HEART MOBILE SERVICES AND FREE BLOOD PRESSURE CHECKS - MOBILE WELL HEART UNIT 7. ACCESS TO PRESCRIPTIONS FUNDING CATHOLIC CHARITIES PRESCRIPTION ASSISTANCE PROGRAM - PRESCRIPTION ASSISTANCE PROGRAM CATHOLIC CHARITIES LOW INCOME 8. ACCESS TO CARE COVENANT PATIENT NAVIGATOR PROGRAM - ADULT PATIENT NAVIGATORS 9. ASTHMA PEDIATRIC ASTHMA NAVIGATOR PROGRAM - PEDIATRIC PATIENT NAVIGATORS ALTHOUGH NO HEALTH CARE FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY, WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH COMMUNITY BENEFIT EFFORTS AND BY FUNDING OTHER NON-PROFITS THROUGH THE COVENANT HEALTH WELLNESS AND PREVENTION GRANTS AND COVENANT HEALTH GRANTS AND CONTRIBUTIONS COMMITTEE. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE DIRECTLY ADDRESSED THROUGH PROGRAMMING OR FUNDING AND AN EXPLANATION IS PROVIDED BELOW: HEALTH NEEDS IDENTIFIED BUT NOT SELECTED AS PRIORITY FOCUS AREAS FOR COVENANT COMMUNITY OUTREACH INCLUDE ADULT DOMESTIC VIOLENCE AND YOUTH SUBSTANCE ABUSE (INCLUDING TOBACCO AND ALCOHOL USE). SEVERAL COMMUNITY PROVIDERS AND NON-PROFIT AGENCIES ARE ADDRESSING THESE NEEDS. COVENANT HEALTH WILL CONTINUE TO PARTNER WITH ORGANIZATIONS ADDRESSING DOMESTIC VIOLENCE SUCH AS FAMILY PROMISE, THE PARENTING COTTAGE AND WOMEN'S PROTECTIVE SERVICES. COVENANT HEALTH WILL ALSO PARTNER WITH ORGANIZATIONS ADDRESSING SUBSTANCE ABUSE SUCH AS TEXAS TECH UNIVERSITY, STARCARE AND MANAGED CARE. IN ADDITION, COVENANT HEALTH WILL COLLABORATE WITH LOCAL ORGANIZATIONS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRALS TO ADDRESS THESE UNMET NEEDS. FOR FURTHER INFORMATION, PLEASE SEE THE IMPLEMENTATION STRATEGY REPORT FOUND AT: HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/MEDICAL-CENTER-FY15-17-CB-PLAN-IMP LEMENTATION-FINAL.PDF. SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. SCHEDULE H, PART V, SECTION B, LINE 16A http://www.covenanthealth.org/documents/Patient-Financial-Assistance/Finan cial-Assistance-Policy-ENGLISH_4.20.16.pdf SCHEDULE H, PART V, SECTION B, LINE 16B http://www.covenanthealth.org/documents/Patient-Financial-Assistance/Finan cial-Assistance-Application-ENGLISH_2.24.16.pdf SCHEDULE H, PART V, SECTION B, LINE 16C http://www.covenanthealth.org/documents/Patient-Financial-Assistance/Coven ant_FABrochure_2016.pdf SCHEDULE H, PART V, SECTION B, LINE 16I THE ORGANIZATION POSTS ITS SUMMARIZED FINANCIAL ASSISTANCE NOTICE IN ALL ADMITTING AREAS IN BOTH ENGLISH AND SPANISH AND PROVIDES THE FULL POLICY UPON REQUEST. SUMMARIZED NOTICES OF THE POLICY ARE AVAILABLE ON ITS WEBSITE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR UNINSURED PATIENTS. BILINGUAL PATIENT ACCOUNT REPRESENTATIVES ARE AVAILABLE TO ADDRESS QUESTIONS AND ASSIST IN THE COMPLETION OF A FINANCIAL ASSISTANCE APPLICATION IN ENGLISH OR SPANISH. SCHEDULE H, PART V, SECTION B, LINE 22D FOR PATIENTS WITH A FAMILY INCOME BETWEEN 176% AND 300% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USED MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR CATASTROPHIC CASES WITH A PATIENT RESPONSIBILITY GREATER THAN $75,000, THE HOSPITAL FACILITY USED MEDICARE RATES TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED. 10 JOE ARRINGTON CANCER RSCH & TRTM CENTER 4101 22ND PLACE LUBBOCK TX 79410 GENERAL MEDICAL & SURGICAL COVENANT LT CARE LP DBA COVENANT SP HOSP 4000 24TH STREET LUBBOCK TX 79410 LONG TERM CARE COVENANT HEART & VASCULAR 3615 19TH STREET LUBBOCK TX 79410 GENERAL MEDICAL & SURGICAL COVENANT HIGH PLAINS SURGERY CENTER LLC 10000 MEMORIAL DR STE 540 HOUSTON TX 77024 SURGERY CENTER LUBBOCK SURGERY CENTER THRU 7312015 2301 QUAKER LUBBOCK TX 79410 SURGERY CENTER METHODIST DIAGNOSTIC IMAGING 4005 24TH STREET LUBBOCK TX 79410 DIAGNOSTIC CENTER FAMILY HEALTHCARE CENTER 7601 QUAKER LUBBOCK TX 79410 MEDICAL CLINIC SOUTHWEST MEDICAL PARK 9812 SLIDE ROAD LUBBOCK TX 79424 GENERAL MEDICAL & SURGICAL FAMILY HEALTHCARE CENTER 416 FRANKFORD ROAD LUBBOCK TX 79410 MEDICAL CLINIC ARRINGTON COMPREHENSIVE BREAST CENTER 4101 22ND PLACE LUBBOCK TX 79410 GENERAL MEDICAL & SURGICAL SCHEDULE H, PART I, LINE 3C IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. SCHEDULE H, PART I, LINE 6A COVENANT HEALTH PREPARES AN ANNUAL REPORT AS A SYSTEM WHICH INCLUDES COVENANT MEDICAL CENTER, COVENANT CHILDREN'S HOSPITAL AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE), AND IT IS PUBLICLY AVAILABLE AT http://www.covenanthealth.org/documents/FY16-Community-Benefit-annual-repo rt-FINAL.pdf SCHEDULE H, PART I, LINE 7A-I THE AMOUNTS REPORTED IN THE TABLE WERE DERIVED FROM THE COST ACCOUNTING SYSTEM AND GENERAL LEDGER. THE ORGANIZATION'S COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. SCHEDULE H, PART III, SECTION A, LINE 2 THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 3 THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS RECEIVED A 100 PERCENT WRITE-OFF OF THE BALANCE DUE. AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, SECTION A, LINE 4 FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT THE HEALTH SYSTEM RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE HEALTH SYSTEM BELIEVES THERE ARE NO SIGNIFICANT CREDIT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED PAYORS ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE HEALTH SYSTEM REGULARLY ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES (EXCEPT FOR AMOUNTS REPORTED IN PART I, LINE 7) AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED USING THE MEDICARE COST REPORT. THE MEDICARE COST REPORT SUBMITTED FOR THE FISCAL YEAR USES CMS STANDARD COSTING METHODS. THIS METHOD INCLUDES SPECIFIC STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS. SCHEDULE H, PART III, SECTION C, LINE 9B COVENANT HEALTH SYSTEM PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT A NEEDS ASSESSMENT IS COMPILED EVERY THREE YEARS WHICH DETAILS OVERARCHING HEALTHCARE CONCERNS FOR TEXAS IN GENERAL AS WELL AS MANY DETAILS AFFECTING THE LUBBOCK COMMUNITY BENEFIT SERVICE AREA IN PARTICULAR. SOME OF THE OTHER SOURCES USED FOR COVENANT'S NEEDS ASSESSMENT INCLUDES: INTERCITY HARDSHIP INDEX (IHI) MAPPING COMPLETED BY ST. JOSEPH HEALTH, THE UNITED WAY COMMUNITY STATUS REPORT, AND THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES DATA. THE PROCESS USED FOR THE PRIORITIZATION OF THE PROGRAMS WAS DETERMINED BY GENERAL CONSENSUS. ALL ASSESSMENTS USED FOR THIS PLAN, PRIMARY AND SECONDARY DATA THAT WAS ANALYZED, INDIVIDUAL MEETINGS WITH GROUPS OF STAKEHOLDERS, AND MEMBERS OF THE COMMUNITY BENEFIT COMMITTEE ALL CONFIRMED THE PROGRAMS WHICH ARE PRIORITIZED FOR THIS PLAN. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION COVENANT HEALTH (CH) IS A MEMBER OF THE ST. JOSEPH HEALTH, SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY, AND IS ONE OF THE LARGEST NON-PROFIT HEALTHCARE ORGANIZATIONS IN THE WEST TEXAS/EASTERN NEW MEXICO REGION, SERVING A 62 COUNTY AREA. MANY OF THE COUNTIES IN THE SERVICE AREA ARE CONSIDERED MEDICALLY UNDERSERVED. WE CONSIST OF 1,154 LICENSED BEDS, APPROXIMATELY 4,000 EMPLOYEES, AND OVER 600 ADMITTING PHYSICIANS. COVENANT HEALTH HAS AN AVERAGE DAILY CENSUS OF 409, OVER 28,000 ANNUAL PATIENT DISCHARGES, AND MORE THAN 85,000 ANNUAL EMERGENCY ROOM VISITS. COVENANT HEALTH COVENANT MEDICAL CENTER, COVENANT CHILDRENS HOSPITAL AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE) ARE ALL LOCATED IN LUBBOCK, TX. LUBBOCK IS THE COUNTY SEAT OF LUBBOCK COUNTY. THE CITY IS LOCATED IN THE NORTHWESTERN PART OF THE STATE AT THE BASE OF THE PANHANDLE IN A REGION KNOWN AS THE LLANO ESTACADO. LUBBOCK IS HOME TO TEXAS TECH UNIVERSITY, LUBBOCK CHRISTIAN UNIVERSITY AND HAS SATELLITE CAMPUSES OF SOUTH PLAINS JR. COLLEGE AND WAYLAND BAPTIST UNIVERSITY. THE LUBBOCK METROPOLITAN STATISTICAL AREA IS COMPRISED OF LUBBOCK AND CROSBY COUNTIES. LUBBOCK SERVES AS AN ECONOMIC CENTER WITH AN ECONOMY BASED IN AGRICULTURE, HEALTHCARE, EDUCATION, AND MANUFACTURING. COVENANT HEALTH (INCLUDING COVENANT MEDICAL CENTER AND COVENANT CHILDREN'S HOSPITAL) IS THE ONLY SJH MINISTRY PROVIDING SERVICES TO COMMUNITIES IN TWO STATES. COVENANT HEALTH PROVIDES SERVICES IN NEW MEXICO AND DRAWS PATIENTS FROM NEW MEXICO COMMUNITIES INTO LUBBOCK. THE CIRCUMSTANCES OF THESE COMMUNITY MEMBERS PROFOUNDLY IMPACT THE ORGANIZATION AND THE SERVICES IT PROVIDES. COVENANT HEALTH'S COMMUNITY BENEFIT PRIORITIES ADDRESS DUHN POPULATIONS WITHIN BOTH CORE SERVICE AREAS AND SECONDARY SERVICE AREAS FOR COMMUNITY RESIDENTS WHO ARE FACED WITH MULTIPLE HEALTH PROBLEMS AND HAVE LIMITED ACCESS TO TIMELY, HIGH-QUALITY HEALTH CARE. CORE SERVICE AREAS INCLUDE THE TEXAS COUNTIES OF LUBBOCK, HALE, HOCKLEY, LOCKNEY, IDALOU, LAMESA, LITTLEFIELD, SHALLOWATER, SLATON, RANSOM CANYON, TAHOKA, AND WOLFFORTH. ESPECIALLY WITHIN LUBBOCK, FOUR NEIGHBORHOODS, ARNETT-BENSON, HARWELL,PARKWAY-CHERRY POINT AND DUNBAR-MANHATTAN HEIGHTS, ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (MUA'S). SECONDARY SERVICE AREAS INCLUDE PARMER, CASTRO, AND KING COUNTIES IN TEXAS. COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH NEEDS (DUHN) ARE COMMUNITIES DEFINED BY ZIP CODES AND CENSUS TRACTS WHERE THERE IS A HIGHER PREVALENCE OR SEVERITY FOR A PARTICULAR HEALTH CONCERN THAN THE GENERAL POPULATION WITHIN COVENANT HEALTHS SERVICE AREA. THE TWENTY ZIP CODES (REPRESENTING TEN CITIES) WITHIN THE COVENANT HEALTH PRIMARY COMMUNITY BENEFIT SERVICE AREA ARE CONSIDERED MEDICALLY UNDERSERVED. FOR A COMPLETE COPY OF COVENANT HEALTH, COVENANT MEDICAL CENTERS, COVENANT CHILDRENS HOSPITAL AND COVENANT SPECIALTY HOSPITALS FY14 CHNAS VISIT: http://www.covenanthealth.org/documents/Medical-Center-CHNA-Final-2014.pdf SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH REALIZING OUR MISSION: COVENANT HEALTH IS AN ACUTE-CARE HOSPITAL LOCATED IN LUBBOCK SERVING THE FOLLOWING REGION WEST TEXAS/EASTERN NEW MEXICO REGION. COVENANT HEALTH PROVIDES VITAL HOSPITAL AND COMMUNITY SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE (TRADITIONAL CHARITY CARE) AND DISCOUNTED CARE. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) THERE IS A COMMUNITY BENEFIT COMMITTEE THAT IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES, 2) AN OPEN MEDICAL STAFF AND 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ARE IN PART FUNDED BY CARE FOR THE POOR DOLLARS. COVENANT HEALTHS FY15-FY17 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON WELLNESS AND PREVENTION INCLUDING DIABETES PREVENTION AND MANAGEMENT, CHILDHOOD OBESITY PREVENTION AND HEART HEALTH EDUCATION, ORAL HEALTH FOR ALL AGES AND MENTAL HEALTH OUTREACH. WELLNESS AND PREVENTION FOCUSED PRIMARILY ON ADULT DIABETIC EDUCATION, OBESITY PREVENTION FOR CHILDREN, ADULT CARDIAC HEALTH EDUCATION AND EARLY ORAL HEALTH INTERVENTIONS FOR CHILDREN; A FULL TIME HEALTH EDUCATOR IS DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH/NUTRITION EDUCATION FOR ALL AGES; FUNDING FOR CHILDHOOD OBESITY AND WELLNESS PROGRAMS IS PROVIDED TO COMMUNITY AGENCIES; PARTICIPATION IN HEALTH SCREENINGS AND HEALTH FAIRS; FUNDING FOR WELL HEART PRESENTATIONS; ORAL HEALTH EDUCATION PROVIDED ON-SITE AT ELEMENTARY SCHOOLS ORAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP; MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK; FREE REGIONAL DENTAL SEALANT CLINICS FOR SCHOOL CHILDREN MENTAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES. COVENANT HEALTH UNDER THE GUIDANCE OF THE COMMUNITY BENEFIT COMMITTEE OPERATES THREE DIRECT COMMUNITY OUTREACH PROGRAMS, PROVIDES GRANTS/CONTRIBUTIONS TO MANY LOCAL CHARITABLE ORGANIZATIONS AND PROVIDES FUNDING AND SUPPORT TO TEXAS TECH UNIVERSITY FOR A CHILDHOOD OBESITY PROGRAM (CBMI). THE THREE DIRECT COMMUNITY OUTREACH PROGRAMS ARE FOR LOW-INCOME PERSONS IN OUR COMMUNITY. DENTAL CLINIC: THE COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES IN OUR REGION. THE PROGRAM OFFERS COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP. ADULT AND CHILDRENS SERVICES ARE AVAILABLE AT A CLINIC IN LUBBOCK. AN ADULT MOBILE DENTAL UNIT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK. A DENTAL SEALANT PROGRAM IS OFFERED TO LOW INCOME AREA SCHOOLS FREE OF CHARGE. PATIENTS MUST FINANCIALLY QUALIFY TO ACCESS THE CLINICAL SERVICES. SOME PATIENT CO-PAY AMOUNTS ARE REQUIRED. PATIENTS ARE NEVER TURNED AWAY DUE TO A LACK OF ABILITY TO PAY. COUNSELING CENTER PROGRAM: COVENANT COMMUNITY OUTREACH COUNSELING CENTER EMPLOYS THREE LICENSED PROFESSIONAL COUNSELORS TO PROVIDE COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY. THE CENTER OFFERS INDIVIDUAL COUPLES AND FAMILY THERAPY, IN A SAFE AND ENCOURAGING ENVIRONMENT. CHARGES FOR SERVICES ARE BASED ON A SLIDING FEE SCALE AND PARTICIPANTS MUST FINANCIALLY QUALIFY. PATIENTS ARE NEVER TURNED AWAY DUE TO A LACK OF ABILITY TO PAY. DIABETES PREVENTION AND INTERVENTION PROGRAM (HEALTH EDUCATION): OFFERS FREE DIABETES CLASSES WITH AN EMPHASIS ON EMPOWERMENT AND SELF-MANAGEMENT. IN ADDITION FREE INDIVIDUAL APPOINTMENTS FOR EDUCATION ON DIABETES, CHOLESTEROL AND HYPERTENSION ARE AVAILABLE TO THE COMMUNITY. HEALTH EDUCATION IS AVAILABLE FOR ELEMENTARY SCHOOL CLASSROOM, COMMUNITY CLINICS, AND COMMUNITY CENTERS ON DIET AND EXERCISE FOR DISEASE PREVENTION. HEALTH PRESENTATIONS ARE AVAILABLE FOR COMMUNITY, FAITH-BASED AND SCHOOL GROUPS. COVENANT BODY MIND INITIATIVE: COVENANT PROVIDES FINANCIAL SUPPORT TO TEXAS TECH UNIVERSITY CENTER FOR ADOLESCENT RESILIENCY TO FUND CBMI WHICH IS A WELLNESS INTERVENTION PROGRAM BUILT INTO MIDDLE SCHOOL CURRICULUM. IT IS ALSO A LONGITUDINAL STUDY MEASURING THE EFFECTIVENESS OF A PREVENTION AND INTERVENTION PROGRAM THAT IMPACTS CHILDHOOD OBESITY. THOSE PERFORMING THE STUDY WILL PROVIDE THE COMMUNITY BENEFIT COMMITTEE WITH QUARTERLY UPDATES ON STRATEGY AND MEASURES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM COVENANT HEALTH IS A HEALING MINISTRY OF ST. JOSEPH HEALTH, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY. ST. JOSEPH HEALTH IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITIES IT SERVES. IN 1986, ST. JOSEPH HEALTH SYSTEM CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FINANCIAL ASSISTANCE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH SYSTEM CREATED THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND (FORMERLY KNOWN AS THE ST. JOSEPH HEALTH SYSTEM FOUNDATION) TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. EVERY YEAR, EACH ST. JOSEPH HEALTH HOSPITAL CONTRIBUTES 10% OF THEIR NET INCOME TO THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND TO SUPPORT OUTREACH EFFORTS FOR THE ECONOMICALLY POOR. IN FY16, THE HOSPITAL CONTRIBUTED $3,553,100 TO THE SJH COMMUNITY PARTNERSHIP FUND. THE CONTRIBUTIONS ARE USED TO SUPPORT CARE FOR THE POOR PROGRAMS THAT ARE SELECTED LOCALLY BY EACH HOSPITAL. ST. JOSEPH HEALTH FURTHERMORE RECOGNIZES THAT THE HEALTH OF ANY COMMUNITY DEPENDS ON THE MAINTENANCE AND CREATION OF STRONG STRUCTURES- BOTH PHYSICAL AND SOCIAL- THAT CONTRIBUTE TO THE LONG-TERM WELL-BEING OF PEOPLE. THAT PHILOSOPHY INSPIRED THE INITIATION OF THE ST. JOSEPH HEALTH COMMUNITY INVESTMENT FUND- AN EFFORT TO ENABLE NON PROFIT 501(C)3 ORGANIZATIONS TO ACHIEVE THEIR FULL POTENTIAL AND PLAY A MAJOR ROLE IN THE GROWTH OF THEIR COMMUNITIES. TO LEARN MORE ABOUT ST. JOSEPH HEALTH GO TO STJHS.ORG SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS true ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DR 100 IRVINE CA 92612 330143024 501(c)(3) 3553100 CARE FOR THE POOR HEALTH COMM & FAM THERAPY CLIN MEDICALLY UNDERSERVED CHILDREN PRESCRIPTION ASSISTANCE COMMUNITY ASSISTANCE GRANT GRANT GRANT PRESCRIPTION ASSISTANCE TEXAS TECH UNIVERSITY BOX 41105 LUBBOCK TX 79409 752668014 GOVT 205402 HEALTHIEST COMM & CHILD OB PROGRAM LUBBOCK CHILDREN'S HEALTH CLINIC 302 N UNIVERSITY AVE LUBBOCK TX 79415 750968315 501(c)(3) 71000 MEDICAL SERVICES CATHOLIC CHARITIES DIOCESE OF LUBBOCK 102 AVE J LUBBOCK TX 79401 751966688 501(c)(3) 100000 PRESCRIPTION ASSISTANCE LUBBOCK AREA UNITED WAY 1655 MAIN ST STE 101 LUBBOCK TX 79401 750961812 501(c)(3) 40000 COMMUNITY ASSISTANCE TEXAS HOSPITAL ASSOCIATION FOUNDATION 1108 LAVACA STE 700 AUSTIN TX 78701 260597324 501(C)(3) 10000 GENERAL SUPPORT LUBBOCK UNITED NEIGHBORHOOD ASSOCIATION 1706 23RD ST 104 LUBBOCK TX 79411 752537152 501(c)(3) 10750 GENERAL SUPPORT LUBBOCK DREAM CENTER 1111 30TH STREET LUBBOCK TX 79411 453991946 501(C)(3) 40000 GENERAL SUPPORT WOMEN'S PROTECTIVE SERVICES OF LUBBOCK PO BOX 54089 LUBBOCK TX 79453 751633066 501(c)(3) 7500 PRESCRIPTION ASSISTANCE 9 SCHEDULE I, PART I, LINE 2 DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS DONATIONS MADE TO OTHER ORGANIZATIONS ARE APPROVED BY MANAGEMENT TO ENSURE THEY SUPPORT THE MISSION OF COVENANT HEALTH SYSTEM. NO ADDITIONAL MONITORING IS DONE. X true true true true false false false false false true false RICHARD PARKS EVP W TX E NM/BD MBR/PRESIDENT 0 726692 0 358218 0 77029 0 10600 0 17263 0 1189802 0 0 DARRIN MONTALVO BOARD MEMBER 0 774102 0 692629 0 119544 0 23850 0 34855 0 1644980 0 0 LARRY WARMOTH MD BOARD MEMBER 0 380185 0 0 0 117483 0 8000 0 19302 0 524970 0 0 MICHAEL O'NEILL MD BOARD MEMBER 0 460066 0 14195 0 59307 0 10000 0 19730 0 563298 0 0 MICHAEL ROBERTSON MD BOARD MEMBER (PART YEAR) 0 324762 0 131582 0 31590 0 8632 0 17286 0 513852 0 0 WALTER CATHEY CHS CEO 306956 0 103057 0 42418 0 18221 0 21834 0 492486 0 0 0 JOHN GRIGSON SVP CHIEF FINANCIAL OFFICER 448362 0 170769 0 60373 0 13249 0 16127 0 708880 0 0 0 ROBERT TURNER VP MISSION INTEGRATION 210798 0 78042 0 22227 0 2240 0 22905 0 336212 0 0 0 JAMES KELLY SECRETARY 0 241928 0 94163 0 21657 0 7805 0 20290 0 385843 0 0 CRAIG RHYNE MD CHIEF MEDICAL OFFICER 568644 0 216833 0 96793 0 21200 0 18531 0 922001 0 0 0 KAREN BAGGERLY VP NURSING 294132 0 103238 0 37731 0 23850 0 7114 0 466065 0 0 0 ROBERT SALEM MD SVP Medical Director, Emeritus 317908 0 121031 0 133740 0 23850 0 17293 0 613822 0 0 0 LAWRENCE MARTINELLI Chief Med Informatics Officer 320738 0 121988 0 31817 0 7950 0 14077 0 496570 0 0 0 SHARON PRATHER Chief Governance Officer 249994 0 89922 0 33166 0 23029 0 15774 0 411885 0 0 0 STEVEN BECK SVP Reg Svcs & Gov't Relation 250539 0 88736 0 31493 0 20592 0 15875 0 407235 0 0 0 MURALI NAIR Chief Medical Physicist 311502 0 6120 0 12474 0 21200 0 16387 0 367683 0 0 0 CHRISTINE SHAVER VP Human Resources - COVHS 219239 0 79584 0 25606 0 20253 0 15071 0 359753 0 0 0 KELLY MCDANIEL VP Support Services 200215 0 72886 0 22789 0 18756 0 21198 0 335844 0 0 0 DYANA KERR Regional VP, Finance 148980 0 26957 0 12466 0 7836 0 21074 0 217313 0 0 0 TROY THIBODEAUX FORMER CEO 0 216717 0 225265 0 553127 0 7909 0 2758 0 1005776 0 0 STEVE MCCAMY CMG PRESIDENT (FMR KEY EMPLY) 0 400389 0 136631 0 54204 0 13250 0 1449 0 605923 0 0 CHRIS DOUGHERTY CEO CHILDREN'S HOSPITAL 0 284030 0 125725 0 26851 0 10210 0 21165 0 467981 0 0 SHARON CLARK VP FINANCE 135933 0 0 0 15109 0 7010 0 9895 0 167947 0 0 0 ALAN KING VP REG HOSPITAL (FMR KEY EMP) 0 0 0 0 211374 0 0 0 0 0 211374 0 0 0 SCHEDULE J, PART I, LINE 1A COMPANION TRAVEL ST. JOSEPH HEALTH SYSTEM ALLOWS FOR COMPANION TRAVEL TO CERTAIN PRE-APPROVED, MINISTRY SPONSORED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO THE HEALTH SYSTEM AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. COMPANION TRAVEL IS CONSIDERED TO BE AN ESSENTIAL PART OF THIS EXPERIENCE AND THE COMPANION ACTS AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. THE FOLLOWING OFFICER RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE COMPENSATION: WALTER CATHEY - $4,554 SCHEDULE J, PART I, LINE 3 THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A NARRATIVE FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT DURING THE YEAR: ALAN KING - $211,374 TROY THIBODEAUX - $521,291 SCHEDULE J, PART I, LINE 4B BEGINNING IN JULY 2015, NEW EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PLAN PROVIDES FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND ARE SUBJECT TO A FIVE YEAR OR AGE 65 VESTING SCHEDULE. EXECUTIVES PREVIOUSLY PARTICIPATED IN ANOTHER NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT WAS FROZEN EFFECTIVE DECEMBER 2007, AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED. THIS FROZEN PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. NO EMPLOYEES RECEIVED 457(F) PAYMENTS DURING THE YEAR. SCHEDULE J, PART I, LINE 7 A PORTION OF EXECUTIVES SALARIES ARE PLACED 'AT-RISKARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. MEMPHIS PLACE MALL LTD MICHAEL ROBERTSON/BRD MBR 525939 LEASE OF BUILDING false X MEDICAL EQUIPMENT 60 1317701 COST/SELLING PRICE false true false SCHEDULE M, PART I, LINE 25, COLUMN (B) THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED, NOT THE NUMBER OF ITEMS RECEIVED. FORM 990, PART I, LINE 1 AND PART III, LINE 1 COVENANT HEALTH SYSTEM IS COMMITTED TO EXTENDING THE CHRISTIAN MINISTRY BY CARING FOR THE WHOLE PERSON-BODY, MIND AND SPIRIT, AND BY WORKING WITH OTHERS TO IMPROVE HEALTH AND QUALITY OF LIFE IN OUR COMMUNITIES. FORM 990, PART III, LINE 4A REALIZING OUR MISSION: COVENANT HEALTH HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE PEOPLE IN THE LOCAL COMMUNITY FOR OVER 16 YEARS SERVING THE COMMUNITIES OF WEST TEXAS AND EASTERN NEW MEXICO. COVENANT HEALTH LUBBOCK INCLUDES COVENANT MEDICAL CENTER, COVENANT CHILDREN'S HOSPITAL, COVENANT SPECIALITY HOSPITAL AND COVENANT MEDICAL GROUP. COVENANT HEALTH PROVIDES QUALITY CARE IN THE AREAS OF EMERGENT/URGENT CARE, NEURO SCIENCE, ORTHOPEDICS, CARDIAC SERVICES, MOBILE MAMMOGRAPHY, MOBILE DENTAL, OUTPATIENT CANCER TREATMENT, HEALTH EDUCATION, PRIMARY CARE, WOMEN'S AND CHILDREN'S SERVICES, LONG TERM CARE, AND REHAB SERVICES WITH OVER 4,000 EMPLOYEES COMMITTED TO REALIZING THE MISSION, COVENANT HEALTH IS ONE OF THE LARGEST EMPLOYERS IN THE WEST TEXAS REGION. AS A MEMBER OF THE ST. JOSEPH HEALTH, COVENANT HEALTH IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORSMINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBLITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. PATIENT FINANCIAL ASSISTANCE PROGRAM COVENANT HEALTH MEDICAL CENTER BELIEVES THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY COVENANT HEALTH HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP) THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. IN FY16, COVENANT HEALTH MEDICAL CENTER PROVIDED $27,316,380 IN FREE AND DISCOUNTED CARE. MEDICAID PROGRAM COVENANT HEALTH MEDICAL CENTER PROVIDED ACCESS TO UNINSURED AND UNDERINSURED PERSONS BY PARTICIPATING IN THE FEDERAL AND STATE SPONSORED MEDICAID PROGRAM. IN FY16, COVENANT HEALTH MEDICAL CENTER PROVIDED $11,544,471 IN MEDICAID SHORTFALL. COVENANT HEALTH IS AN ACUTE-CARE HOSPITAL LOCATED IN LUBBOCK SERVING THE FOLLOWING REGION WEST TEXAS/EASTERN NEW MEXICO REGION. COVENANT HEALTH PROVIDES VITAL HOSPITAL AND COMMUNITY SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE (TRADITIONAL CHARITY CARE) AND DISCOUNTED CARE. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) A COMMUNITY BENEFIT COMMITTEE THAT IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES, 2) AN OPEN MEDICAL STAFF AND 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ARE IN PART FUNDED BY CARE FOR THE POOR DOLLARS. COVENANT HEALTHS FY15-FY17 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON WELLNESS AND PREVENTION INCLUDING DIABETES PREVENTION AND MANAGEMENT, CHILDHOOD OBESITY PREVENTION AND HEART HEALTH EDUCATION, ORAL HEALTH FOR ALL AGES AND MENTAL HEALTH OUTREACH. WELLNESS AND PREVENTION FOCUSED PRIMARILY ON ADULT DIABETIC EDUCATION, OBESITY PREVENTION FOR CHILDREN, ADULT CARDIAC HEALTH EDUCATION AND EARLY ORAL HEALTH INTERVENTIONS FOR CHILDREN; A FULL TIME HEALTH EDUCATOR IS DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH /NUTRITION EDUCATION FOR ALL AGES; FUNDING FOR CHILDHOOD OBESITY AND WELLNESS PROGRAMS IS PROVIDED TO COMMUNITY AGENCIES; PARTICIPATION IN HEALTH SCREENINGS AND HEALTH FAIRS; FUNDING FOR WELL HEART PRESENTATIONS; ORAL HEALTH EDUCATION PROVIDED ON-SITE AT ELEMENTARY SCHOOLS ORAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP; MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK; FREE REGIONAL DENTAL SEALANT CLINICS FOR SCHOOL CHILDREN MENTAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES. FOR MORE INFORMATION ABOUT COVENANT HEALTH, PLEASE VISIT HTTP://WWW.COVENANTHEALTH.ORG/. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG. FORM 990, PART V, LINE 1 ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJH ENTITIES UNDER SJH AP SHARED SERVICES. THEREFORE, SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID. SJHS COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM AND LUBBOCK METHODIST HOSPITAL SYSTEM ARE THE CORPORATE MEMBERS OF COVENANT HEALTH SYSTEM. FORM 990, PART VI, LINE 7A POWER TO ELECT OR APPOINT MEMBERS COVENANT HEALTH SYSTEM HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT HEALTH SYSTEM BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE COVENANT HEALTH SYSTEM BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE ST. JOSEPH HEALTH SYSTEM MEMBER APPROVES 50% OF THE BOARD NOMINATIONS, PLUS THE VOTING CEO. THE LUBBOCK METHODIST HEALTH SYSTEM MEMBER APPROVES THE OTHER 50% OF BOARD NOMINATIONS. FORM 990, PART VI, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, LINE 11B PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 WAS THEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2017 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING. FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE. FORM 990, PART VI, LINES 15A & 15B OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED & YEAR PROCESS WAS BEGUN THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. EXECUTIVE COMPENSATION IS APPROVED BY THE COVENANT HEALTH SYSTEM CONFLICTS AND COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE REVIEWS COMPARABILITY DATA PREPARED FOR AND COMPILED BY THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE, A COMMITTEE OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES COMPRISED OF INDEPENDENT MEMBERS. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE ACTS IN ACCORDANCE WITH A COMMITTEE CHARTER APPROVED BY THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES AND AN EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER DIRECTS THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND TO APPROVE PROGRAM CHANGES, AS NECESSARY, TO ENSURE ALIGNMENT WITH THE STATED PHILOSOPHY AND ENSURE CONTINUED COMPLIANCE WITH FEDERAL AND STATE REGULATIONS ON BEHALF OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS RETENTION OF KEY MANAGEMENT TALENT. THE EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF FOR PROFIT AND NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. ST. JOSEPH HEALTH SYSTEM PROVIDES COMPENSATION TO ITS EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO ENSURE COMPENSATION PHILOSOPHY ADHERENCE AND GENERAL FAIR MARKET VALUE COMPENSATION, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA AND ENGAGES LEGAL COUNSEL AND CONSULTING SUPPORT, AS NEEDED. THEY USE THIS INFORMATION TO SUPPORT ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE MEETS AT LEAST 3 TIMES A YEAR AND TAKES ACTION IN EXECUTIVE SESSION. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. A FULL COMPENSATION REVIEW IS CONDUCTED ON A BIENNIAL BASIS AND THE LAST REVIEW WAS PERFORMED IN JUNE 2016. DURING THE YEAR, THE COVENANT HEALTH SYSTEM CONFLICTS AND COMPENSATION COMMITTEE REVIEWED AND APPROVED ANY CHANGES IN COMPENSATION FOR KEY EXECUTIVES PREDICATED ON THE ANALYSIS AND RECOMMENDATION BY AN INDEPENDENT THIRD PARTY CONSULTING FIRM WITH EXPERTISE IN HEALTHCARE EXECUTIVE COMPENSATION. IN ADDITION, ANNUAL INCENTIVE AWARDS ARE REVIEWED AND APPROVED PRIOR TO PAYMENT CONSISTENT WITH THE MOST RECENT COMPENSATION BIENNIAL REVIEW AND IN ACCORDANCE WITH THE PLAN DOCUMENT. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES WHICH ARE SUBSEQUENTLY APPROVED AT THE COMMITTEE MEETING. FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS EQUITY TRANSFER $ 29,911,503 CONTRIBUTED CAPITAL $ (6,348,702) CARE FOR THE POOR $ (2,668,039) OTHER ADJUSTMENTS $ 13,385,288 -------------- TOTAL $ 34,280,050 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:47350699 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:56811468 COVENANT LTC-GP LLC 4000 24TH STREET LUBBOCK TX 79410 205477333 HEALTHCARE TX 0 0 CHS CHS HOLDING GP LLC 4000 24TH STREET LUBBOCK TX 79410 205477307 HEALTHCARE TX 0 0 CHS COVENANT HEALTH NETWORK INC 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 461259908 HEALTHCARE CA 501(C)(3) 11,III SJHS true COVENANT ACO 3615 19TH STREET LUBBOCK TX 79410 611573313 HEALTHCARE TX 501(C)(3) 11,I CHS true COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(C)(3) 7 CHS true COVENANT MEDICAL GROUP 3420 22ND PLACE LUBBOCK TX 79410 752743883 HEALTHCARE TX 501(C)(3) 3 CHS true COVENANT HEALTH PARTNERS 3615 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MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE 362, MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 100, ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 200 ORANGE, CA 92868-2012 THE INNOVATION INSTITUTE EIN: 90-0745066 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110, PETALUMA, CA 94954 MISSION VIEJO PHYSICIAN PARTNERS I LLC EIN: 47-1559873 ADDRESS: 27700 MEDICAL CENTER ROAD, MISSION VIEJO, CA 92691 ADVANCED SURGERY INSTITUTE LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404